Geisinger Medical Laboratories Test Catalog

Order Display Name: Geisinger Epic Procedure Code Or ID CPT Code:  

FACTOR VIII (8) CLOTTING ACTIVITY

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB2257         Geisinger Epic ID: 7123

SPECIMEN COLLECTION
Specimen type:
 Platelet-poor plasma
Preferred collection container:
Alternate Collection Container:
Other size blue-top (3.2% sodium citrate) tubes (e.g., 1.8 mL, 4.5 mL)
Specimen required:
1 mL aliquot plasma for a single factor study. Each additional factor study requires an additional 0.5 mL aliquot. Samples requiring heparin neutralization require an additional 0.5 mL for each factor.
Special notes:
  • If the patient’s hematocrit (HCT) is >55%, the volume of anticoagulant in the tube must be adjusted. Contact a performing location for sodium citrate adjusted tubes or instruction for how to adjust the sodium citrate.
  • When possible, use fresh venipuncture.
  • Avoid prolong tourniquet time (< 1 minute) and hemolysis during collection as this will alter results.
  • If indwelling catheter or butterfly collection device must be used, draw sample from a non-heparinized lumen or flush the line with 5 mL of saline and discard/use first 5-10 mL of blood for other purposes.
  • Tubes should be >90% filled.
  • Immediately mix gently after collection by inverting the tube end over end 5 to 6 times. Avoid vigorous mixing or additional inversion. Observe for the presence of clots or hemolysis and recollect if observed.
SPECIMEN PROCESSING
Specimen processing instructions:
Specimen processing instructions: Centrifuge specimen immediately at designated time and speed to obtain platelet-poor plasma (<10,000/µL). Using a plastic pipette, carefully remove plasma from cells, avoiding platelet/buffy layer by leaving a thin layer of plasma on top the cells. The centrifuged plasma should be aliquoted (1 mL per aliquot) into clearly labeled polypropylene tubes. The number of tests ordered will determine the aliquots needed. Check the residual specimen for clot and if present discard sample and redraw specimen. If plasma is icteric, lipemic or hemolyzed a lab comment should be generated to notify staff. Freeze upright in non-thaw freezer. 
Transport temperature:
 Frozen on dry ice
Specimen stability:
 Room temperature (whole blood): 4 hours
Room temperature (plasma off cells): 8 hours
Frozen (plasma) -20°C: 2 weeks
Frozen (plasma) -70°C: 6 months
Rejection criteria:
 Clotted, hemolyzed, improperly filled tubes, improper anticoagulant ratio (HCT >55% and citrate not adjusted), refrigerated specimens, or stability exceeded. Note: Specimen suspected of thawing in transport, indicated by slant in aliquot or specimen in lid of tube, will have testing performed, and the comment “interpret results with caution as thawing suspected” added to results.
TEST DETAILS
Reference interval:
 GMC: 55-145%
GWV: 60-150%
Additional information:
 Anticoagulation Impact on Coagulation Tests
CPT code(s):
 85240
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.  The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.
Test includes:
 Factor VIII activity
Methodology:
Mechanical clot-based
Synonyms:
Factor VIII, Factor 8, Hemophilia A, FA8
Clinical significance:
Factor VIII is a protein critical to clotting. It is part of the intrinsic clotting cascade. Factor VIII activity assay can be useful in evaluating the reason for a prolonged aPTT. Very low levels may result in bleeding and are seen in hereditary and acquired hemophilia A, as well as some von Willebrand disease subtypes. Elevated levels are common and are typically from an acute inflammatory state because the protein is an acute phase reactant. Elevated factor VIII activity not associated with an acute reactant have been shown to be associated with a higher risk of thrombosis, however, treatment for elevated factor VIII levels is controversial. Correlation of factor VIII to fibrinogen levels is recommended to determine if factor 8 activity is the patient’s baseline state (normal fibrinogen) or an acute phase reactant (elevated fibrinogen).
Doctoral Director(s:)
Michelle Grant DO    
Review Date: 03/31/2023

Performing Locations

Geisinger Medical Center

Performing laboratory: Coagulation
Technical Lead: Margaret Knowles-Tuchman
Frequency: Daily, 8 a.m. - 5 p.m. For STAT testing, please call the laboratory.
Performed STAT? Yes

Geisinger Wyoming Valley Medical Center

Performing laboratory: ATL+
Technical Lead: Mary Glazenski    
Frequency: Daily, 8 a.m. - 5 p.m. For STAT testing, please call the laboratory.    
Performed STAT? Yes
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